The Police State We Call Health Care

I have some news for you. We are living in a police state! I am sorry, as I know it hurts to hear that we choose to live in bondage.

Don’t be fooled by shiny title of being a health care professional, the pennies on the dollar we get paid from the ridiculous pool of money we generate, and the lifestyle that we were promised but rarely experience.

We are watched 24/7 because of the title we carry. We are judged for every word we say, whether at work or outside work. We are evaluated by students, patients, residents, co-workers and supervisors. I have not seen any evaluation for a patient, many of whom should be charged with some extra payment for abusing the system or the team. And the residents we can evaluate are protected by a system called ACGME, who might retaliate by giving a bad score for the training program if that program did not crucify us. We became hostages by our own doing.

Your life outside work is not yours to control. Your Facebook and Twitter accounts are watched. You will be judged for the opinions you express. And sure enough you might even be disregarded for some promotion because of your beliefs, practices or orientation. The stigma of being from this race, a graduate of this institution, having this sexual orientation, being from this background or finishing at a foreign school is alive and thriving behind closed doors. Let’s be honest about it.

I have seen it around me happening in the past. You have to join a crowd, but which crowd? The oppressors? The oppressed? It cannot be both. The academics of medicine also is infected with this disease. You have to be from a certain closed circle to rise. You have to compromise your righteous path in order to gain.

You cannot call in sick. You must sacrifice your personal life. You need to go “above and beyond,” simply because that is expected. We are the victims and the criminals at the same time.

Heaven forbid you give feedback to a resident who felt it was harsh (despite his or her limited knowledge). We avoid consulting services daily, because we do not want to deal with the frustrations. I have seen how residents from surgery or orthopedics can be dismissive of your concerns, how they can delay care for hours, and how they can request unnecessary studies before even seeing the patient. And if you become forceful about timely evaluation or treatment, trust me – you will hear about it later. Who is suffering here? I think patients and the emergency team equally.

We spend a significant amount of our time addressing nonsense scenarios. We are fostering this culture, because we accept it. I see myself drifting every day into accepting this wrongdoing by people around me. I cannot blame a patient or the family if our own team members are not functioning as they are supposed to.

Recently, I had a very nice chat about this culture with a brilliant pediatric surgeon who recognized how it limits our ability to provide excellent and efficient care. We reached a realization that our culture need to be changed. This change will be a long road filled with many hardships.

We have to stop judging others. We have to quit the hierarchy. We have to eliminate the unnecessary hoops that we have to jump through. We need a system that cares about patients more than the bottom line. We have to create a system that holds health care professionals and patients equally accountable. And most importantly, we need to eliminate this notion that we are an industry. I might be a dreamer in this police state called health care.

What do you think about this topic? Please share your experiences and thoughts.